ShowMe WorldCare End User Manual

The Clinical tab will vary greatly by condition. Generally, this tab contains information related to the patient’s medical record. Examples of the types of sections that may commonly appear on the Clinical tab for many conditions are briefly described below.

SMWC Tip: The Clinical tab utilizes many business rules that enable particular fields only when certain criteria have been met. For example, a user may not be able to enter an onset date for a specific system unless they have indicated that the patient experienced that specific system. These business rules 1) prevent inappropriate data entry and 2) help users know which fields actually need to be completed.

SMWC Tip: The Clinical tab for some conditions can be lengthy. Specific conditions may have different business rules that determine which sections are expanded or collapsed by default. For example, all sections on the COVID-19 Clinical tab are set to be collapsed by default with only the section headers visible for easy navigation. Each section can be expanded or collapsed by clicking the + / - button to the left of the section header. In addition, the purple and green + / - buttons in the upper right corner of the Clinical tab can be very useful for expanding/collapsing multiple sections at once. The green button expands or collapses all sections. The purple button can be used to expand/collapse empty sections.

Interview Date: The user can document when interviews with the patient occurred. This is a repeating section so the Add button can be used to document multiple dates if the patient is contacted more than once.

Clinical Information: The section generally asks if the patient is symptomatic and follow-up questions. Onset date will be pulled into this section from the Administrative tab.

Signs and Symptoms / Complications / Clinical Presentations: The lists in these sections for will vary for each condition and were pulled from existing case report forms or other reference materials.

Medical History – Pre-Existing Conditions: This is a place to document whether the patient has any pre-existing conditions that may put them at risk due to their current reportable condition. These questions usually cover a general category, such as Chronic Lung Disease. If the patient indicates they have chronic lung disease and the user enters Yes, a follow-up box will be enabled so the specific type of chronic lung disease can be entered.

Medical History – Other Medical Conditions: This section asks if the patient was immunocompromised at the time of diagnosis. If yes, follow-up boxes allow entry of specific types of immunodeficiency as well as medication(s), disease(s) or other condition(s) the patient has that may weaken their immune system.

Medical History – Past Diagnosis: If the patient has been previously diagnosed with this condition, that information can be documented in this section. This information can be very helpful to investigators.

• Some conditions can only be contracted once. If the person responds that they have been previously diagnosed with one of those conditions, that provides a clue to the investigator that perhaps the person should not be counted as a new case.
• If the person had a previous episode of the disease, the investigator may wish to obtain records related to the earlier incident. Fields in this section allow documentation of the timing and the patient’s residence at the time of the prior diagnosis.

Vaccination Status / Query ShowMeVax / Vaccination History (Details): These sections are available for conditions which have vaccines.

• The first section asks several general status questions.
• The Query ShowMe Vax section contains a summary table showing any vaccines previously entered. Clicking on the information in any row in the table will open a detailed record of that vaccination in the Details section.
• The Query ShowMe Vax section also contains a button labeled ShowMeVax. If this button is called, a call for data is sent to the ShowMeVax system and will pull in any vaccine records for that person.
  • If there are multiple possible matches in ShowMeVax, a pop-up of the options will appear so the user can select the correct person.
  • Clicking on the ShowMeVax button multiple times will result in duplicate vaccines loading from ShowMeVax. If that happens, simply click the Delete button at the bottom of the duplicate section. (This may occur if a user has returned to the record to see if the person has received another vaccine since the last follow-up. It is okay that the duplicate vaccines load as they can be deleted.)
• BEST PRACTICE: If a system user has received a report of a vaccine that does not appear when the ShowMeVax button is used, please enter that vaccine in ShowMeVax since that is the official record for vaccinations in the State of Missouri. While it is possible to enter the vaccination into the Details section in ShowMe WorldCare, that information will NOT be sent to ShowMeVax and that vaccination will be missing from the official record.

Hospitalization/Hospitalization Details: If the user indicates the patient was hospitalized in the Hospitalization section, additional questions will be enabled in that same section and the Hospitalization Details section will expand. Click on the first blank ID number in the summary table or click the Add button at the lower right of the Details section to add information about the specific hospitalization.

• The Hospital Name should be searched in the dictionary using the drill-down button to the right of that field. Various search boxes at the top of the Location Dictionary pop-up can be used to find the appropriate hospital. Click on the hospital name followed by OK at the bottom of the pop-up box to select a hospital. If the hospital is not included in the Location Dictionary, enter the hospital information in the next field. DHSS staff will monitor that field and add those hospitals to the Location Dictionary.
• If the Admit date and Discharge / transfer date fields are completed, Total number of days should calculate automatically.
• When finished entering details about one hospitalization, click Add to enter details about another hospitalization. Otherwise click OK to exit the Hospitalization Details pop-up.

Treatment / Management: If the user indicates the patient received treatment for this condition, the Treatment / Management Details section will be enabled and expand. Click on the first blank ID number in the summary table or click the Add button at the lower right of the Details section to add information about the specific treatment. Some conditions will contain fields with specific lists of drugs. Others may provide more general fields in which treatment names may be typed. When finished entering details about one treatment, click Add to enter details about another treatment. Otherwise click OK to exit the Treatment / Management Details pop-up.

Outcome/Pregnancy Outcome: This Outcome section contains three main subsections.

• Case Outcome can be used to document the resolution of the case. Depending on the selection made, additional questions may enable so further detail can be provided. For example, if the case was Lost to follow-up, the reason can be indicated.
• A death data section allows documentation related to causes of death and autopsy.
• If the patient is a Fetus/Newborn, a section allows documentation related to the impact of the condition on the pregnancy/birth. If the patient is a pregnant person, this section should be left blank but the Pregnancy Outcome section should be completed. It contains questions about the condition’s impact on the pregnancy/birth.

Public Health Interventions/Tasks/ Case Notes: These sections will be described in more detail later in this manual.

When finished with all sections for the particular condition, Save the record and click Next to move to the next tab, which is typically the Epidemiologic tab.